Anti-Inflammatory Dinners for Endometriosis: What the Evidence Says

Search for an endometriosis diet and you will find long lists of foods to avoid and promises of an “anti-inflammatory” fix. The honest picture is more modest. Around one in seven Australian women born in the 1970s had been diagnosed with endometriosis by their late forties, according to the AIHW, and many want to know whether food can help. This guide explains what the guidelines and research actually say, where anti-inflammatory eating fits, and shares one simple dinner built on the foods with the most interest behind them.

What the guidelines say

The 2022 ESHRE guideline concluded that no recommendation can be made for any specific nutrition intervention to reduce pain or improve quality of life in endometriosis, because the potential benefits and harms are unclear. It noted that, based on a few studies, clinicians may suggest fish oils as an alternative to more harmful anti-inflammatory medicines.

Australia’s living endometriosis guideline from RANZCOG goes slightly further. It suggests that clinicians discuss diet advice (a low FODMAP diet) and dietary supplements (fish oil and vitamin D) with people with endometriosis to manage pain, but that people should be told the evidence of benefit is limited. Jean Hailes says there is no direct evidence that nutrition influences endometriosis, but a healthy diet is important for overall wellbeing.

What “anti-inflammatory” eating means here

Endometriosis involves inflammation, so it makes sense that people look to foods linked with lower inflammation. The best-known study is from the US Nurses’ Health Study II, a large group of nurses followed over many years, in which 1,199 women had endometriosis confirmed by surgery. Those with the highest intake of long-chain omega-3 fats (the kind in oily fish) were 22% less likely to be diagnosed with endometriosis, and those with the highest trans fat intake were 48% more likely. Because this was an observational study of diagnosis, it cannot tell us whether eating more fish reduces symptoms in someone who already has endometriosis.

When fish oil has been tested directly, results have been mixed. A 2020 trial in 69 young people aged 12 to 25 found fish oil did not reduce pain more than a placebo. Systematic reviews of diet and endometriosis pain have found that most studies report some benefit, but that they are small and at moderate or high risk of bias.

In practice, “anti-inflammatory” eating usually means a pattern built on vegetables, fruit, wholegrains, legumes, nuts, seeds, olive oil and oily fish, with fewer highly processed foods. That pattern is in line with the Australian Dietary Guidelines and is good for health in general, even if its effect on endometriosis pain is not proven.

When the gut is the problem

Many people with endometriosis have bloating, pain and bowel symptoms that overlap with irritable bowel syndrome. A 2025 randomised crossover trial from Monash University in 35 women found 60% responded to a low FODMAP diet compared with 26% on a control diet, with improvements in abdominal pain, bloating and quality of life. A low FODMAP diet is meant to be done in stages with a dietitian and is not a long-term way of eating, because cutting out many foods for too long can affect nutrition and gut bacteria.